Provider Demographics
NPI:1831934348
Name:PROMPTCARE HOME INFUSION, LLC
Entity type:Organization
Organization Name:PROMPTCARE HOME INFUSION, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:LARIVIERE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-776-6782
Mailing Address - Street 1:41 SPRING ST STE 103B
Mailing Address - Street 2:
Mailing Address - City:NEW PROVIDENCE
Mailing Address - State:NJ
Mailing Address - Zip Code:07974-1143
Mailing Address - Country:US
Mailing Address - Phone:866-776-6782
Mailing Address - Fax:
Practice Address - Street 1:108 LUNDY LN STE 120
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39401-6601
Practice Address - Country:US
Practice Address - Phone:601-910-7279
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-26
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy